Should epinephrine be used with local anesthesia for dental procedures in adult patients who previously had heart failure? Researchers from Brazil recently conducted a study to find out.
They randomly assigned 72 patients to receive or not receive epinephrine as part of their anesthetic before treatment. Except for more reported pain in the group without epinephrine, there were no differences between the groups, the researchers found. They presented the study in a poster at the American Heart Association's (AHA) Scientific Sessions on November 11.
"Local anesthesia solution lidocaine with epinephrine seems to be safe and effective in patients with heart failure," the researchers wrote.
The double-blind randomized controlled trial was led by Sergio Quaresma of the Heart Institute at the University of São Paulo in Brazil.
Using a local anesthetic with a vasoconstrictor for patients undergoing dental procedures is controversial because of the possibility of an adverse cardiovascular event, the researchers wrote. This is the first study to examine the use of lidocaine with and without epinephrine in patients with previous heart failure, according to the group.
A total of 72 patients scheduled for tooth extraction and restoration were randomly assigned to receive lidocaine with or without epinephrine.
Systolic and diastolic blood pressure increased significantly in both groups during the procedure, and maximum heart rate decreased significantly, the researchers noted. However, no differences were reported in blood pressure, heart rate, and arrhythmias between the groups. The patients who did not receive epinephrine did report a significant increase in pain, however.
The researchers did not cite any study limitations, and they concluded that treatment with epinephrine did not cause adverse cardiovascular effects.
"Patients with [heart failure] may benefit from the anesthesia solution with epinephrine for the dental intervention," they wrote.
